Inhaled nitric oxide: current and future uses in neonates.

Abstract:

:Inhaled nitric oxide (iNO), a selective pulmonary vasodilator, is available for treatment of persistent pulmonary hypertension of the newborn in term and near-term neonates. iNO decreases pulmonary vascular resistance leading to diminished extrapulmonary shunt and also has a microselective effect which improves ventilation/perfusion matching. Clinical trials indicate the need for extracorporeal membrane oxygenation (ECMO) is diminished by iNO. Information suggests a 20 ppm starting dose; doses greater than 40 ppm offer no advantage. The typical duration of therapy in responders is less than one week. Several approaches to weaning have been successful. Abrupt discontinuation should be avoided. Ventilatory management remains important when parenchymal lung disease accompanies pulmonary hypertension of the newborn; HFOV used to optimize lung inflation facilitates the action of iNO. Non-ECMO centers should be able to provide iNO during transport to an ECMO center. Data suggest a possible role for iNO in preterms with hypoxemic respiratory failure and studies in this group should proceed.

journal_name

Semin Perinatol

journal_title

Seminars in perinatology

authors

Kinsella JP,Abman SH

doi

10.1053/sper.2000.20085

keywords:

subject

Has Abstract

pub_date

2000-12-01 00:00:00

pages

387-95

issue

6

eissn

0146-0005

issn

1558-075X

pii

S0146-0005(00)80002-6

journal_volume

24

pub_type

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